Medical Insight

  • Current Integrative approach to Headache Management

    Headaches are one of the most common symptoms that a person may experience. Nearly all people will experience a headache at some point in their lives. Headaches may affect anyone regardless of age or gender. Headache disorders are one of the most common disorders of the nervous system. According to the National Headache Foundation, over 45 million Americans suffer from recurring headaches, and of these, 28 million suffer from migraine. Additionally, 20% of children experience regular headaches. Headache disorders often have a large impact on one’s quality of life, and this may include a financial impact. Chronic headache sufferers may have increased incidence of anxiety, depression, sleep disturbance, and chronic fatigue symptoms.

    Most often, headaches are benign, and are of the tension or migraine type. However, headaches may be secondary to other medical conditions. So, one should inform their health care provider if they are newly experiencing headaches or if headaches have changed in any way. While some headache sufferers will respond to lifestyle modification alone, others will require headache management through the use of a headache preventative (prophylactic) medication or other specific therapy.

    Headache abortive medications are fast-acting and can be effective in bringing control of a headache when it occurs. These medications are good to have available when a headache occurs but are not intended to treat, that is reduce the overall occurrence of the headaches, as a headache preventative medication does. Triptans, which include Imitrex, are effective medications in this category.

    Headache preventative, or prophylactic, therapy is the management of headaches through the use of a daily medication, and is a staple of headache management. While only about 10% of migraine sufferers who are appropriate for this therapy are on it, nearly 40% of them are candidates for this treatment. So, there are still a large number of migraine sufferers that can benefit from this therapy. There are various medication options which your physician can discuss with you. While antihypertensive medications, the beta blockers (ie. propranolol and timolol) and anticonvulsant medications (ie. divalproex sodium and topiramate) currently are the only approved by the U.S. Food and Drug Administration for migraine prevention, there are many others have been used extensively off label for migraine prevention. Headache sufferers with headaches more frequent than 2 per month, those with prolonged headaches, and with headaches significantly affecting their lifestyle should be considered for this treatment.

    Living a healthier lifestyle is certainly one of the most effective ways to manage headaches. Headache sufferers should take measures to avoid potential triggers such as specific foods, alcohol, or tobacco. Certain foods such as aged cheeses which contain Tyramine, foods high in preservatives, chocolate, and highly caffeinated products are infamous for causing headaches. But for some people it is not limited to these foods. It is good to maintain a regular meal schedule and maintain good practices of sleep hygiene. Regular exercise and stress management play a vital role in headache avoidance. Maintaining hydration is very important as well. Regardless of the new headache therapies that may become available in time, lifestyle modification will always be key.

    Lastly, there are various other treatment options including injection therapy and Botox therapy for select persons. BOTOX® (onabotulinumtoxin A) is a prescription medicine that is administered using a very fine needle directly into the targeted facial muscles.  It is used to prevent headaches in adults with chronic migraine, those who specifically have 15 or more days of headaches each month with headaches lasting 4 or more hours each day. The medication may also offer hope for those that have not responded to alternative therapies.

    In summary, adherence to lifestyle modification, regular preventative treatment, and follow-ups with your physician will best assure optimal headache control and the best quality of life possible.

    Jason Reinhart, DO
    Nov 04, 2016
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